MANY doctors are becoming disillusioned with their involvement in Primary Care Trusts, preventing them from delivering their key roles and responsibilities, according to a new paper.

Primary Care Trusts (PCTs), which came into force across England in a major overhaul of the NHS structure in April last year, were created to remove numerous tiers in local health care and deliver money direct from Whitehall.

But a report published by leading organisations involved in primary care warned that doctors were pulling back from involve-ment in the fledgling groups.

The British Medical Association's general practitioners committee, the NHS Alliance, the National Association of Primary Care and the Royal College of GPs said that if PCTs were to meet the Government's objectives in the NHS plan, local doctors needed to play an important role in their work.

They said that in many cases this was not happening, with GPs becoming less involved in PCTs than in earlier organisations and frontline staff left disillusioned in their roles.

The joint paper puts forward a number of recommendations to make sure local needs are met and more decision-making and financial freedom is genuinely devolved. These include freedom for PCTs to innovate within modernisation plans and the provision of care as close as possible to patients' homes.

This year saw PCTs given star ratings by the Commission for Health Improvement for the first time, with 45 given the top three stars.

The paper notes that the priorities for involving doctors in PCT work and redesigning services should be part of a "credible and relevant, quality system of star ratings for PCTs".

They added: "It is imperative that clinicians working in primary care are fully engaged and involved in PCTs, as frontline doctors, nurses and allied professionals have the best working knowledge of the needs of their local communities."

A Department of Health spokesman said: "All clinicians must be able to play an active role in how their PCTs are run in order for them to work effectively.

"To support this, members of the National Primary Care and Trust Development Programme (NatPaCT) are working closely with the Department of Health, the National Association of Primary Care, the NHS Alliance, the Modernisation Agency's Leadership Centre and clinical leaders in PCTs to address the issue of clinical engagement.

"The work covers a range of issues which will ultimately provide clinical leaders in PCTs with the skills, support and develop-ment they need to ensure that they are able to engage with and influence how their PCT is run and contribute effectively to the redesign of local health services," he added.